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The  Vital  Statistics 


Apache  Indian  Community 


W.    C.    BORDEN,    M.  IX, 

CAPTAIN,  MEDICAL  DEPARTMENT,  UNITED  STATES  ARMY. 


Reprinted  from  the  Boston  Medical  and  Surgical  Journal 
of  July  6,  1893. 


BOSTON: 

DAMRELL   &  UPHAM,  PUBLISHERS, 

No.  283  WASHINGTON  STREET. 

1893. 


THE   VITAL   STATISTICS  OF  AN   APACHE  IN 
DIAN   COMMUNITY. 

BY  W.   C.   BORDEN,   M.T>., 

Captain,  Medical  Department,  United  States  Army. 

THESE  statistics  are  of  a  community  of  nearly  pure- 
blooded  Indians  living  in  abnormal  environment. 

As  accurate  vital  statistics  of  American  Indians  are 
rare,  if  not  unknown,  this,  and  the  fact  that  they  show 
the  effect  of  changed  environment  upon  a  nomadic 
people,  give  these  statistics  their  particular  interest. 
The  lack  of  other  accurate  statistics  of  Indian  commu 
nities  gives  no  normal  averages  for  purposes  of  com 
parison,  making  it  impossible  to  determine  the  exact 
amount  of  divergence  from  usual  rates  which  changed 
environment  has  caused  in  this  community.  The  ex 
tent  of  the  effect  produced  must,  therefore,  remain 
inferential  ;  but  that  there  has  been  a  decided  depart 
ure  from  the  normal  will  be  plainly  seen  from  the 
statistics  themselves. 

These  statistics,  which  are  for  a  period  of  five  years, 
from  July  1,  1887,  to  June  20,  1892,  were  compiled 
by  the  writer  from  the  official  records  of  the  military 
post  at  Mount  Vernon  Barracks,  Ala.,  while  on  dury 
there  during  the  summer  of  1#92,  and  are  those  of 
the  Apache  Indians  now  kept  there  under  military 
supervision  and  control.  This  Indian  community  num 
bers  about  four  hundred  (men,  women  and  children, 
see  Table  I),  and  is  composed  of  various  Apache 
bands,  among  them  being  the  noted  Geronimo  and  his 
followers,  of  Arizona  fame. 

The  Apaches  have  lived  for  generations  in  Arizona 
and  the  adjacent  parts  of  Old  and  New  Mexico,  becom- 


M150720 


ing  thereby  constitutionally  adapted  to  the  dry,  rarefied 
air  and  clear,  diathermic  atmosphere  of  the  elevated 
regions  of  the  southwestern  part  of  the  United  States. 

They  are  essentially  nomadic  and  warlike  in  habit, 
and  deserving  of  their  appellation  "  Ishmaelites  of  the 
West";  they  have  not  only  been  notoriously  hostile  to 
the  whites  but  to  alien  Indian  tribes  as  well. 

This  hostility  to,  and  non-affiliation  with  aliens,  has 
kept  these  Indians  remarkably  free  from  an  admixture 
of  foreign  blood ;  so  much  so,  that  in  this  community 
of  about  four  hundred,  there  are  but  five  persons  in 
whom  white  blood  can  be  traced.  In  1886,  after  nu 
merous  outbreaks  and  hostilities  and  their  capture  by 
United  States  troops,  the  Indians  now  forming  this 
community  were  removed  from  Arizona  and  taken  to 
Fort  Marion  and  Fort  Pickens,  Fla.  They  remained 
there  but  a  few  months,  and,  in  April,  1887,  they 
were  removed  to  Mount  Vernon  Barracks,  where  they 
now  are. 

Their  condition  during  their  stay  in  Florida  was  ex 
tremely  bad.  Brought  in  from  the  fatigues  of  the 
war-path  and  the  destitution  of  their  hunted  camps, 
they  were  taken  from  the  clear,  dry  and  rarefied  air  of 
Arizona  to  the  humid  atmosphere  and  debilitating  cli 
mate  of  the  Florida  sea-coast.  They  were  supplied 
with  rations  and  clothing,  but  were  crowded  into  damp 
and  improperly  ventilated  quarters. 

Here  the  first  effects  of  such  radical  change  of  envi 
ronment  began  to  manifest  themselves,  and  clearly 
pointed  to  the  necessity  of  an  attempt  to  better  their 
condition.  Their  removal  to  Mount  Vernon  Barracks 
effected  a  temporary  improvement ;  as  on  their  arrival 
there,  they  were  placed  in  tents  while  a  village  of  log 
cabins  for  their  occupancy  was  being  built.  This  vil 
lage  was  completed  before  the  end  of  the  year ;  but 
the  cabins  were  of  the  worst  type  of  construction,  and 


the  site  was  unsanitary,  being  in  a  low,  damp  hollow- 
so  shaded  by  trees  that  free  circulation  of  air  and  pen 
etration  of  sunlight  were  greatly  interfered  with — a 
serious  matter  where,  as  in  Southern  Alabama,  the 
humidity  of  the  atmosphere  is  great  and  the  rain-fall 
excessive. 

They  lived  in  this  village  for  four  years,  during 
which  time  its  condition  and  the  health  of  the  Indians 
became  so  bad  that  finally  it  was  found  necessary  to 
build  another;  and  in  1891,  a  much  better  village  of 
framed  houses  was  built  on  a  hill  near  by,  where  the 
disadvantages  of  the  old  site  did  not  obtain.  In  May 
of  the  same  year,  46  of  the  able-bodied  men  were  en 
listed  as  privates  in  the  United  States  Armv,  forming 
Company  I,  Twelfth  Infantry,  which  was  increased  by 
the  arrival  of  32  Touto  Apaches  from  Arizona,  some 
two  mouths  later.  Captain  W.  W.  Wotherspoon, 
U.  S.  A.,  who  had  been  placed  in  charge  of  the  Indians 
shortly  before^  and  by  whose  efforts  the  building  of  the 
new  village  was  undertaken,  was  given  command  of 
the  company,  and  ably  instituted  reforms  in  the  gen 
eral  and  sanitary  condition  of  the  community.  A  com 
modious  barrack  was  built  for  the  Indian  enlisted  men  ; 
and  a  hospital  with  male  and  female  wards  was  com 
pleted  the  same  year.  By  these  means  the  condition 
of  the  community  was  greatly  improved. 

In  fact,  as  regards  its  sanitary  condition  during  the 
five  years  for  which  statistics  are  given,  there  are  two 
distinct  periods. 

During  the  first  period  of  about  four  years,  they 
lived  under  the  unsanitary  conditions  of  bad  location, 
wretched  habitation  and  accumulating  filth.  Their 
village  was  on  a  damp  and  overshaded  soil,  and  their 
cabins  were  of  the  worst  construction.  They  were 
built  of  rough  logs,  with  mud  or  rough  board  floors, 
and  with  windows  too  small  to  admit  sufficient  sun- 


light.  The  roofs  leaked,  and  the  crevices  between  the 
logs  were  imperfectly  closed.  They,  therefore,  af 
forded  but  poor  protection  against  the  inclemency  of 
the  weather,  and  were  damp,  gloomy,  dirty,  and  in 
every  way  unsanitary.  The  Indians  being  unused  to 
living  in  permanent  dwellings,  allowed  dirt  to  accumu 
late  in  and  about  them,  as  they  were  accustomed  to 
do  with  their  temporary  "  wickyups "  in  Arizona. 
The  latter,  however,  being  frail  structures  of  poles  and 
brush-wood,  lasted  but  a  short  time,  and  were  generally 
abandoned  before  dirt  had  accumulated  to  an  unsanitary 
extent,  while  the  cabins,  being  permanent,  gradually 
accumulated  filth  until  they  became  veritable  incuba 
tors  of  disease. 

The  Indians  themselves  were  in  no  better  condition 
than  their  habitations.  They  received  regular  and 
abundant  issues  of  rations  and  clothing;  but  as  none 
of  them  were  regularly  employed  at  paid  labor,  they 
were  without  money,  and,  although  forbidden,  they 
sold  all  they  could  of  both  food  and  clothing  to  obtain 
it.  The  money  so  received  they  spent  to  no  advan 
tage  to  themselves. 

Captivity,  unaccustomed  restraint  and  enforced  idle 
ness  operated  to  prevent  the  mental  stimulus  of  per 
sonal  endeavor  and  combined  with  their  unsanitary 
surroundings  to  produce  a  condition  of  mental  and 
physical  demoralization.  As  a  result,  the  death-rate 
(see  Table  J)  gradually  increased  until  for  the  year 
ending  June  30,  1891,  it  reached  the  extremely  high 
rate  of  142  per  1,000  of  living. 

During  the  last  period  of  one  year,  beginning  July 
1,  1891,  the  condition  of  the  community  was  improved 
in  all  ways. 

Their  new  village  being  on  the  crest  of  a  hill  has 
plenty  of  sunlight  and  free  circulation  of  air.  The 
houses  are  of  fairly  good  construction,  are  well  lighted 


by  good-sized  windows,  are  plainly  built,  and  are  easily 
kept,  clean. 

The  enlistment  of  many  of  the  men,  and  the  em 
ployment  of  most  of  the  others  at  paid  labor  about 
the  village  and  garrison,  removed  the  demoralizing 
effect  of  enforced  idleness  and  gave  the  Indians  a 
mental  stimulus  the  effects  of  which  can  hardly  be 
overrated. 

They  are  now  well  clothed  and  well  supplied  with 
the  necessities  of  life,  while  cleanliness  of  person  and 
habitation  is  enforced  by  rigid  military  inspections  and 
method.  The  Indian  company,  in  neatness  and  in  the 
well-kept  condition  of  its  barrack,  compares  favorably 
with  any  white  company  in  the  United  States  Army. 

The  improved  condition  of  the  community  during  the 
Jast  year,  over  that  of  the  preceding  four  years,  is 
shown  by  the  following  extract  from  a  report  of  an 
inspection  made  by  Colonel  Charles  Page,  Medical 
Director  of  the  Department  of  the  East,  in  which  he 
says  :  "The  Indian  camp  and  hospital  have  been  much 
improved  and  the  quarters  with  surroundings  occupied 
by  the  prisoners  are  as  clean  as  those  occupied  by  the 
soldiers.  The  transformation  from  squalor  to  neat 
and  tidy  condition  of  quarters  and  grounds  is  remark 
able."  ' 

This  bettered  condition  produced  a  marked  effect 
upon  the  mortality  of  the  community  and  the  death- 
rate  fell  (see  Table  I)  from  142.58  per  1,000,  of  the 
preceding  year,  to  109.75.  The  number  of  deaths 
from  all  causes  except  tuberculosis  fell  (see  Table  II) 
from  35  to  18;  and  had  the  deaths  from  tuberculosis 
decreased  in  like  ratio,  the  death-rate  would  have  been 
lowered  remarkably.  Instead  of  this,  the  deaths  from 
tuberculosis  decidedly  increased  in  number  —  the  germs 
of  the  disease  having  been  so  thoroughly  disseminated 
during  the  preceding  years. 


This  general  description  of  the  condition  of  these 
Indians  during  the  five  years  will  make  clear  the  cir 
cumstances  under  which  the  following  statistics  were 
produced : 

TABLE  I.  —  Showing  the  mean  number,  according  to  age  and  sex, 
of  Apache  Indians  present  at  Mount  Vernon  Barracks,  Ala., 
for  each  of  the  Jive  years  beginning  July  1,  1887,  and  ending 
June  30,  1892  ;  the  number  of  deaths  according  to  age  and  sex ; 
the  number  oj  births;  and  the  birth-  and  death-rates  per  1,000 
for  the  same  years. 


Mean    num 

||        0 

ber  present 
(corrected  for 

Deaths. 

Births. 

5 

s 

time). 

I 

I 

Year. 

*. 

i 

% 

2 

-' 

g 
• 

£ 

I 

'S* 

E 

if 

c 

£ 

I 

ft 
-r 

5 

a 

| 

2 

"2 

1 

5 
c 

1 

oj 

s 

§ 

z 

s 

1 

1 

_c 

1 

£ 

§ 

3 

1887-88   .     .     . 

78 

170 

118 

36f 

1 

11 

8 

20 

9 

8 

17 

54.64 

46.44 

1888-89   .    .     . 

8G 

179 

123 

3SS 

2 

7 

in 

19 

7 

10 

17 

48.96 

43.66 

1889-90   .     .     . 

92 

176 

124 

391' 

6 

13 

24 

43 

6 

28 

34 

109.69 

86.73 

1890-91    .    .     . 

9:i 

105 

107 

811 

9 

11 

33 

63 

10 

8 

18 

142.58 

48.51 

1891-92   .    .     . 

122 

169 

119 

411! 

10 

11 

21 

45 

16 

15 

31 

109.75 

75.61 

Totals     .    . 

28 

53 

09 

180 

48 

89 

117 

Mean  death-rate  for  the  five  years      .       .        .    93.12 

Mean  birth-rate  for  the  five  years        .        .        .    60.19 

Excess  of  deaths  over  births         .        .        .        .63 

Excess  of  female  births  over  male      ...        .21 

*  Under  twelve  years  of  age.  The  division  is  made  at  this  age,  as 
official  record  is  so  kept  on  account  of  those  over  twelve  receiving  a 
full  ration  from  the  government,  while  those  under  that  age  receive 
one-half  a  ration. 

The  high  birth-  and  death-rates  at  once  attract  at 
tention.     The  mean  birth-rate  of  60.1  is  nearly  double 


that  of  civilized  communities.  The  general  average 
in  European  countries  for  1882  was  34.1  per  1,000  of 
population,  the  lowest  rate  being  24.8,  and  the  highest 
44.6,  while  the  lowest  rate  of  this  community  during 
the  five  years  was  43.6,  and  the  highest  86.7. 

The  mean  number  of  women  over  twelve  years  of 
age,  present  during  the  five  years,  was  171  ;  and  as 
there  were  117  births,  the  number  of  births  during 
that  time  was  equal  to  68.4  per  cent,  of  the  mean 
number  of  women  present,  including  those  past  and 
those  who  had  not  reached  the  menstrual  period. 

During  the  year  of  lowest  birth-rate  there  was  one 
birth  to  every  ten  women  ;  and  during  the  year  of 
highest  rate,  one  woman  in  every  five  gave  birth  to  a 
child. 

There  are  two  main  causes  for  the  high  birth-rate  : 
great  freedom  of  union  of  the  sexes,  and  the  practice 
of  polygamy. 

By  great  freedom  of  union  of  the  sexes,  unchastity 
is  not  meant,  but,  as  most  of  the  conditions  which 
with  a  civilized  people  lead  to  sexual  restraint,  do  not 
obtain  with  these  Indians,  early  union  of  the  sexes 
occurs,  and  the  ties  so  formed  are  easily  broken  that 
other  connections  may  be  made.  Infidelity  is  rare 
during  their  marital  alliances,  but  these  alliances  are 
generally  broken  at  the  caprice  of  either  party.  The 
wife  is  usually  obtained  by  purchase  ;  but  curiously, 
the  right  of  the  parents,  and  particularly  of  the  mother, 
to  a  daughter  so  disposed  of,  does  not  end  with  her 
marriage.  The  husband  only  retains  her  during  their 
approval ;  and  payments  of  money  or  other  valuables 
are  extorted  from  him  under  threat  of  taking  her  from 
him.  Curiously,  also,  the  right  of  the  mother  seems 
not  to  be  questioned  by  the  married  daughter  ;  and 
she,  obediently  and  apparently  willingly,  returns  to 
her  parents  when,  deeming  that  insufficient  tribute  is 
paid,  they  order  her  to  do  so. 


8 

Polygamy  is  practised ;  and  as  the  women  approach 
the  menopause,  the  men  form  new  ties  with  younger 
women.  It  will  be  seen  that  the  family  is  not  devel 
oped  as  with  civilized  people,  but  that  sexual  relations 
are  generally  formed  on  the  basis  of  sexual  activity. 

As  shown  by  Table  I,  the  women  are  about  double 
the  men  in  number ;  but  the  practice  of  polygamy  and 
of  the  men  taking  younger  wives  when  the  older  are 
past  the  child-bearing  period,  gives  as  great  oppor 
tunity  for  all  the  women  to  bear  children  as  there 
would  be  in  a  community  where  there  was  an  equal 
number  of  each  sex.  In  consequence  of  the  excess  of 
women,  it  must  be  borne  in  mind,  when  comparing 
the  birth-rate  of  this  community  with  that  of  a  civil 
ized  people,  that  an  increase  of  men  would  not  in 
crease  the  births,  but  would  decrease  the  birth  rate. 

At  the  same  time,  consideration  must  be  given  the 
probability  that  this  condition  is  a  normal  one  for  this 
and  other  uncivilized  people  —  the  greater  exposure 
of  the  men  from  warfare  and  other  conditions  of  life, 
probably  tending  constantly  to  keep  their  number 
reduced  below  that  of  the  women. 

It  may  be  well  to  state,  that  it  does  not  follow,  be 
cause  of  their  practice  of  polygamy  and  the  ease  with 
which  their  marriages  are  made  and  broken,  that  these 
Indians  are  immoral.  Their  standard  of  morals  is 
different  from  that  of  a  people  of  higher  civilization. 
It  is  in  keeping  with  their  conditions  of  life  and  stage 
of  race  development ;  and  judged  by  it,  they  have  al 
ways  been  considered  virtuous.  They  are  quite  free 
I  from  venereal  diseases.  During  the  five  years  there 
were  treated  but  two  cases  of  syphilis,  one  case  of 
urethral  stricture,  one  of  gleet,  and  thirteen  cases  of 
gonorrhoea.  As  before  stated,  there  are  but  h've  in 
dividuals  of  mixed  (Indian  and  white)  blood  in  the 
community. 


It  is  claimed  by  persons  having  long  acquaintance 
with  these  Apaches,  that  they  have  always  practised 
infanticide  of  all  infants  of  mixed  blood  ;  but  as  they 
have  never  well  affiliated  with  the  whites,  it  is  proba 
ble  that  occasion  for  such  practice  has  been  infrequent. 
During  the  five  years  of  close  observation  at  Mount 
Vernon  Barracks  no  instance  of  such  practice  has 
been  observed  ;  and  but  one  half-breed  child  has  been 
born. 

What  effect,  if  any,  their  changed  environment  has 
had  upon  the  birth-rate  of  these  people,  is  difficult  of 
determination. 

Their  enforced  idleness  during  the  first  four  years, 
so  different  from  the  activity  of  their  former  nomadic 
life,  may  have  had  a  tendency  to  increase  the  rate ; 
but,  on  the  other  hand,  it  would  seem  that  a  decreased 
rate  would  be  produced  by  the  high  death-rate  and  the 
increased  amount  of  sickness  which  would  necessarily 
accompany  it. 

How  high  the  death-rate  was  will  be  seen  from  Table 
T,  which  shows  a  minimum  rate  of  48.9,  a  maximum 
of  142.5,  and  a  mean  of  93.1  per  1,000  of  living;  so 
that  in  spite  of  the  very  high  birth-rate,  the  deaths  ex 
ceeded  the  births  by  63. 

The  following  table  shows  the  causes  of  death  which 
produced  this  high  rate,  and  the  relative  frequency  of 
each  cause  (see  next  page)  : 

This  table  shows  at  once  that  tuberculosis,  diar- 
rhceal  diseases,  and  malnutrition  of  children  were  the 
great  causes  of  death. 

Of  the  total  of  180  deaths,  78,  43^  per  cent,  were 
caused  by  tuberculosis  alone ;  while  malnutrition  of 
children  and  diarrhoeal  diseases  together  caused  49 
deaths,  or  27£  per  cent,  leaving  but  53  deaths,  or  29f 
per  cent,  for  all  other  diseases.  It  is  plain  from  these 
figures,  that  the  high  death-rate  of  these  Indians  is 


TABLE  II.  —  Showing  the  causes  of  death,  the  number  of  deaths 
from  each  cause  during  each  year  and  during  the  Jive  years, 
and  the  percentage  of  deaths  from  each  cause  to  the  total  num 
ber  of  deaths. 


Causes  of  death. 

Number  of  deaths  each  year. 

2 
>» 

10 

"08 
I 

4J 

01 

0, 

'87-88 

'88-89 

'£9-90 

'90-91 

'91-92 

11 

4 

18 

18 
1 

27 
2 

78 
1 
2 

43.33 
.55 
1.11 

Scrofula  

Chronic  rheumatism    .    . 

General  debility,  adults  . 
Old  age 

1 

2 

1 

4 

1 

3 

2 
5 

1 

2 

8 
10 

1.11 
4.44 

5.55 

Malnutrition,  children     . 

Acute  diarrhoaa   .... 

3 

7 

13 

3 

26 

14.44 

Chronic  diarrhoea    .    .    . 

1 

1 

5 

4 

2 

13 

7.22 

Obstruction  of  bowels  .    . 
Peritonitis        .... 

1 
1 

1 

1 
1 

3 
1 

1 
1 

2 
1 

2 
5 
2 
2 
2 
2 

1.11 
2.77 
1.11 
1.11 
1.11 
1.11 

Stomatitis    

Asphyxia  of  new-born 
Croup  .         ...... 

Capillary  bronchitis     .    . 

Chronic  pleurisy  .... 
Pneumonia  

1 

1 

1 

1 

3 

1 

1 
5 
1 
1 

.55 
2.77 
.55 
.55 

Asthma    

Acute  nephritis    .... 

Chronic  nephritis     .    .    . 

1 

1 
1 

1 

2 

1 
2 

1 

2 
2 
1 

5 

1.11 
1.11 

.55 

2.77 

Poisoned,  Ind'n  medicine 

Suicide     .    .    .    .... 

•• 

1 

1 

.55 

Unknown,  infant     ,.    .    . 

2 

2 

2 

6 

3.33 

Totals 

20 

19 

43 

53 

45 

80 

100.00 

11 

due,  primarily,  to  the  prevalence  of  tuberculosis  among 
them,  and  secondarily,  to  diseases  of  the  alimentary 
organs.  The  reasons  for  the  prominence  of  intestinal 
disease  as  a  cause  of  death  are  readily  ascertained. 
Most  of  the  deaths  from  diarrhoeal  diseases  were  of 
children,  as  will  be  seen  from  the  following,  which 
gives  the  number  of  adults  and  of  children  dying  of 
these  diseases : 

Infants.    Adults.    Total. 
Acute  diarrhoea       ......       21  5  26 

Chronic  diarrhoea 11  2  13 

Totals       .......        32  7  39 

So  that  of  the  39  deaths  from  diarrhoeal  diseases,  the 
large  number  of  32,  or  82  per  cent.,  were  of  children. 
These  32  deaths  added  to  the  10  deaths  of  children 
from  malnutrition  account  for  42  of  the  180  deaths. 

The  infant  mortality  of  civilized  people  is  notoriously 
high ;  and  it  is  naturally  to  be  expected  that  with 
these  people  the  rate  would  be  still  higher,  as  the 
great  causes  of  infant  mortality,  namely,  ignorance  in 
regard  to  the  proper  care  and  feeding  of  children, 
would  exist  in  greater  degree.  Improper  care  exists 
at  all  times;  improper  feeding  generally  does  not 
begin  until  the  time  for  weaning  approaches.  It  is 
rare  to  find  an  Indian  mother  who  cannot  nurse  her 
child,  for  in  the  past,  in  those  cases  where  the  child 
could  not  be  nursed,  it  died,  so,  gradually,  through 
the  law  of  the  survival  of  the  fittest,  a  race  was  pro 
duced  whose  women  can  nurse  their  children  —  a  con 
dition  general  with  uncivilized  people  —  the  resources 
of  civilization  being  necessary  to  produce  the  common 
occurrence  of  deficient  mammary  function  by  saving 
the  lives  of  non-nursing  mothers  and  so  transmitting 
the  tendency.  But,  when  weaning  occurs,  the  Indian 
children  pass  directly  to  the  diet  of  the  adults ;  and  as 


12 

the  diet  range  of  the  Indians  is  limited,  and  their 
knowledge  ot  cooking  very  imperfect,  children  with 
weak  digestion  are  almost  sure  to  contract  acute  bowel 
complaints,  which,  aggravated  by  continued  improper 
feeding,  generally  prove  fatal. 

The  improper  feeding  of  children  was  undoubtedly 
as  common  with  these  Indians  previous  to  their  re 
moval  from  Arizona  as  it  has  been  since,  but  other 
disease-predisposing  factors  have  been  added  by  their 
change  to  their  present  place  of  abode,  which  have 
helped  to  produce  a  high  infant  mortality.  In  the  hot 
and  moist  air  of  summer,  which  prevails  in  Southern. 
Alabama  during  seven  months  of  the  year,  putrefac 
tive  changes  quickly  occur  ;  the  improperly  kept  and 
poorly  cooked  food  of  the  Indians  is  apt  10  take 
such  change,  and  is,  consequently,  often  given  to  the 
children  when  in  anything  but  proper  condition.  From 
the  elevation  of  Arizona  and  New  Mexico,  the  air 
there  is  dry,  and  putrefactive  changes  are  much  less 
apt  to  occur.  There  the  Indians  habitually  preserve 
their  meat  by  drying  in  the  sun  and  air;  but  in  South 
ern  Alabama  meat  so  treated  (and  the  Indians  from 
habit  still  attempt  to  so  cure  it)  almost  invariably 
spoils,  and  is  frequently  eaten  by  them  and  fed  to  the 
children  after  it  has  begun  to  decompose. 

To  improper  feeding  is  added  improper  clothing. 
During  the  first  four  years  the  clothing  of  the  children 
was  insufficient  to  protect  them  against  the  ill  effects 
of  temperature  changes  ;  and  this,  together  with  great 
dampness  of  the  ground  from  frequent  rains,  had 
great  effect  in  producing,  or  predisposing  to,  intestinal 
catarrhs. 

It  is  probable,  therefore,  that  the  change  of  climate 
from  Arizona  to  Southern  Alabama,  together  with  the 
unsanitarv  conditions  of  the  first  four  years,  produced 
a  decided  increase  of  infant  mortality  from  intestinal 


13 

diseases.  But,  while  the  death-rate  from  these  dis 
eases  was  very  high,  that  from  tuberculosis  was  still 
higher;  and  the  effect  of  changed  environment  in  pro 
ducing  a  high  death-rate  from  this  disease  was  most 
marked.  How  fatal  tuberculosis  was,  and  that  it  was 
the  main  cause  of  death,  is  shown  by  Table  II  and  by 
the  following  table  or  tabulated  comparisons : 

TABLE  III. —  Showing  comparative  death-rate  for  1,000  Jiving. 
Men.     Women.    Children.    Totals. 

Mean  number  present  during  )     „_  .  l"l  8  1182 

the  five  years         .        .          I 


Died  of  tuberculosis 
Died,  all  other  causes      . 
Died,  all  causes 
Death-rate  from  tuberculosis 
Death-rate,  all  other  causes 
Death-rate,  all  causes 


21  29  28  78 

7  24  71  102 

28  53                99  180 

42.53  32.67  46.1  J0.45 

14.17  27.03  11G.8  52.65 

56.7  59.7  162.9  93.10 


Death-rate,  England  and  Wales,  all  causes,  1881-90    .    .  19.15 
Death-rate,  England  and  Wales,  tuberculosis,  1881-90    .    2.15 

The  death-rate  of  the  men,  women  and  children 
from  tuberculosis  is  remarkably  similar  for  so  small  a 
number  of  observations,  and  shows  how  uniformly 
fatal  the  disease  has  been.  While  the  mean  death- 
rate  of  the  world  from  tuberculosis  is  not  far  from  2 
per  1.000  of  living,  the  average  death-rate  of  this  com 
munity  from  it  has  been  40.35.  This  rate  shows  the 
virulency  and  epidemic  quality  of  this  disease  in  this 
community  ;  for  the  rate  exceeds  that  of  cholera  in 
the  worst  infected  districts  during  an  epidemic,  and  is 
more  than  four  times  greater  than  was  the  rate  from 
small-pox  in  London  during  the  years  from  1771  to 
1781,  when  the  latter  disease  was  at  its  height. 

The  high  death-rate  of  the  children,  from  causes 
other  than  tuberculosis  (116.8),  is  accounted  for  by 
the  prevalence  of  diarrhceal  and  malnutrition  diseases, 
before  referred  to. 

The  death-rate  of  adults,  from  causes  other    than 


14 

tuberculosis,  14.17  for  the  men,  and  27.03  for  the 
women,  is  not  high,  being  a  mean  of  only  a  little 
over  20  per  1,000  of  living,  which  is  about  that  of 
the  world  at  large  ;  so  that,  so  far  as  the  adults  are 
concerned,  had  their  mortality-rate  from  tuberculosis 
been  the  usual  one  of  2  per  1,000,  their  rate,  while 
high  for  adults,  would  have  been  but  22  per  1,000  of 
living. 

It  is  generally  accepted,  however,  that  the  death- 
rate  of  Indians  from  tuberculosis  is  always  greatly  in 
creased  whenever  they  are  confined  to  given  localities 
and  their  usual  habits  of  free  life  interfered  with.  Nor 
can  such  increased  death-rate  be  considered  strange, 
for,  in  their  natural  state,  an  unconscious  adaptation  of 
themselves  to  their  environment  has  taken  place  for 
them  by  which  a  normal  balance  of  life  is  obtained. 

The  Apaches  have  lived  for  generations  in  the 
clear,  dry,  rarefied  air  of  the  Rocky  Mountain  up 
lands.  Their  habitations  are  of  the  frailest  kind, 
,/  open  to  the  drying  air  and  penetrating  sunlight  of 
those  regions.  From  their  nomadic  habits,  they  move 
frequently  from  place  to  place,  leaving  behind  them 
the  dirt  accumulated  by  living,  and  abandoning  their 
frail  and  soiled  habitations  for  new  ones.  When  one 
of  their  number  dies,  the  habitation  in  which  the  death 
occurs  is  burned,  and  the  belongings  of  the  deceased 
person  are  also  burned  or  buried.  In  this  way,  by 
abandonment  and  burning  —  natural  disinfection  meth 
ods —  communicable  diseases,  of  which  tuberculosis 
is  one,  were  in  large  part  avoided. 

Only  through  long  generations  of  gradual  adapta 
tion  and  natural  training  can  a  nomadic  people  adjust 
themselves  to  the  living  requirements  of  permanent 
habitation.  With  these  Indians  the  experiment  was 
made  —  unintentional  as  an  experiment,  it  is  true  — 
of  taking  them  suddenly  from  nomadic  life  and  thrust- 


15 


ing  them  unprepared  by  previous  natural  training  into 
a  life  of  quiescence  and  permanent  habitation.  The 
result  is  shown  by  the  extremely  high  death-rate,  par 
ticularly  from  tuberculosis.  The  relative  frequency 
with  which  this  disease  in  its  different  forms  caused 
death  among  the  men,  women  and  children  is  given  in 
the  following  table : 


Forms  of 
Tuberculosis. 

Deaths  from  each  form. 

Totals. 

Per  cent. 

Men. 

Women. 

Children. 

Pulmonary  .    .     . 

19 

27 

11 

57 

73 

Enteric     .... 

1 

2 

11 

14 

17.9 

Meningeal    .    .    . 

1 

.. 

6 

6 

7.6 
1.2 

Totals     .    .    . 

21 

29 

28 

78 

The  frequency  of  pulmonary  tuberculosis  as  a  cause 
of  death  with  adults,  and  of  enteric  and  meningeal 
forms  with  children,  is  noticeable,  and  in  keeping  with 
general  observations  upon  this  disease. 

The  great  frequency  in  children  of  mesenteric  tu 
berculosis  has  been  frequently  observed  before,  and 
the  ingestion  of  infected  milk  has  been  considered  as 
the  main  cause.  This  view  seems  to  be  supported  by 
these  statistics,  as  the  prevalence  of  tuberculosis  among 
the  mothers  would,  in  this  way,  produce  many  cases 
other  than  pulmonary  even  were  the  children  not  in 
fected  when  born. 

The  great  predominance  of  pulmonary  tuberculosis 
among  the  adults  is  also  in  keeping  with  general  ob 
servations  —  the  infection  with  them  generally  occur 
ring  by  way  of  the  lungs. 


16 

It  is  not  so  plain  why  deaths  from  this  disease  have 
been  proportionately  so  much  greater  among  the  men 
of  this  community  than  among  the  women,  unless  it  is 
that  the  somewhat  less  active  life  of  the  women  has 
given  them  a  certain  degree  of  immunity.  It  is  more 
probable,  however,  that  this  is  not  the  case,  and  that 
no  such  difference  would  be  found  if  the  numbers  from 
which  the  statistics  are  derived  were  larger.  In  fact, 
the  whole  question  of  immunity  to  tuberculosis,  and 
of  the  different  susceptibility  of  different  races  to  this 
disease,  is  not  yet  settled.  It  is  well  known  that  cer 
tain  races,  as  the  nomads  of  Persia,  Syria  and  Arme 
nia,  and  the  inhabitants  of  certain  localities,  as  those 
of  Iceland  and  the  islands  of  Faroe,  Shetland  and  the 
Hebrides,  are  almost,  if  not  entirely  free  from  the  dis 
ease ;  while  among  negroes  in  this  country,  and  In 
dians,  when  under  restraint  and  in  contact  with  civili 
zation,  it  is  particularly  prevalent.  It  is  also  known 
that  under  changed  conditions  the  same  race  exhibits 
an  apparently  varying  susceptibilitv  to  the  disease,  as 
is  shown  by  its  appearance  among  the  nomadic  races 
above  referred  to  as  soon  as  they  abandon  their  wan 
dering  life. 

Also,  it  is  known  to  vary  according  to  differences  in 
locality  or  climate;  its  spread  being  favored  by  viti 
ated  and  damp  air  and  a  moist  soil,  and  retarded  by 
purity  and  dryness  of  the  air,  and  a  large  amount  of 
sunshine.  In  view  of  these  facts,  it  seems  probable 
that  tuberculosis  acts  as  does  any  other  infectious  dis 
ease,  being  most  prevalent  where  the  conditions  favor 
ing  its  spread  most  obtain  ;  and  that  the  presence  of 
these  conditions,  more  than  racial  or  individual  suscep 
tibility,  are  the  important  factors  favoring  its  preva 
lence.  This  view  is  supported  by  the  death-rate  from 
this  disease  of  the  community  under  consideration. 

For  some  months  previous  to  their  arrival  at  Mount 


17 

Vernon  Barracks,  and  during  the  first  four  years  of 
their  stay  there,  all  the  conditions  most  favorable  to 
the  spread  of  the  disease  existed  ;  and  the  deaths  from 
it  ran  as  follows  :  First  year  11,  second  year  4,  third 
year  18,  fourth  year  18,  fifth  year  27. 

During  the  fifth  year,  though  the  condition  of  the 
Indians  was  greatly  improved,  the  number  of  deaths 
from  this  disease  was  greater  than  before,  as  the  dis 
ease  had  gained  such  a  foothold  during  the  preceding 
four  years  that  no  decrease  could  be  looked  for  in  so 
short  a  time.  The  disease  is  so  slow  in  development 
and  in  running  its  course,  that  when  unusually  preva 
lent  in  a  community,  no  sudden  return  to  ordinary 
rates  can  be  expected,  but  only  a  slow  decline  made 
possible  by  most  thorough  sanitary  measures. 

Whether  the  system  of  disinfection  and  enforced 
cleanliness  now  being  carried  out  in  this  community 
together  with  its  bettered  condition,  will  be  effective 
in  staying  the  ravages  from  this  disease  remains  to  be 
seen,  for  the  unfavorable  conditions  of  changed  climate 
and  altered  modes  of  life  still  remain. 

It  is  to  be  hoped,  however,  that  this  most  insidious  of 
diseases  can  be  controlled  by  the  means  taken  and  not 
withstanding  that  the  past  five  years  have  shown  a 
steady  increase  of  the  disease,  due  to  the  presence  of 
all  the  conditions  most  favorable  to  its  spread,  that  the 
following  years,  through  the  absence  of  many  of  these 
conditions  and  the  use  of  suppression  methods,  may 
show  a  steady  decline. 

Should  such  decline  occur,  it  will  be  of  interest  in 
that  it  will  show  the  adaptation  of  the  community  to 
its  new  environment,  and  the  effectiveness  of  modern 
sanitary  methods,  when  enforced. 


r 


14H1AY  USE 

FROM  WHICH  BORROWED 

LOAN  DEPT. 

This  book  is  due  on  the  last  date  stamped  below,  or 

on  the  date  to  which  renewed. 
Renewed  books  are  subject  to  immediate  recall. 

SENT  ON  ILL 


SEP  1  9  1935 


U3 


U.  C.  BERKELEY 


/ 

f 

&"    —<  r- 

LD  21A-50m-8,'61 
(Cl795slO)476B 


General  Library 

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M150720 


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